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Jung M, Lee KO, Kim HR, Koh SB, Gim JA. Four modeling approaches to study restrictions on everyday life and social activities due to chronic diseases with consequences of suicidal behavior. J Psychiatr Res 2024; 173:355-362. [PMID: 38581904 DOI: 10.1016/j.jpsychires.2024.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/20/2024] [Accepted: 03/24/2024] [Indexed: 04/08/2024]
Abstract
The purpose of this study was to discover the association between disability in everyday life and social activities due to chronic diseases and suicidal ideation (SI), suicidal plan (SP), and suicidal attempt (SA) from the Korea National Health and Nutrition Examination Survey (KNHANES), considering the cross-sectional design of this study, 2016-2018 dataset. Variables for finding the associated factors of SI, SP, and SA were confirmed through random forest (RF), decision tree, generalized linear model (GLM), and support vector machine (SVM), and the performance of each model is listed. A total of 17,323 (males: 7,530, females: 9793) responders from the KNHANES from 2016 to 2018 were employed for the study. The relationship between restrictions on daily life, social activities, and three stages of suicidal behaviors due to diseases were analyzed using the R function (R version 4.2.0), randomForest, ctree, glm, and ksvm. The F1-score is a measure used to evaluate the accuracy of the performance of a model, in the binary classification. The score of 1 indicates good performance, whereas a score of 0 signifies poor performance. Due to chronic diseases, disability in everyday life and social activities lead to suicide behaviors. In our study, we examined the impact of limitations in daily living and social activities on suicidal behaviors among participants. Our findings revealed that for those experiencing such limitations, the odds ratios (ORs) for SIs were 6.10 (95% CI: 3.99-9.34) for males and 2.61 (1.79-3.81) for females. SPs were 3.69 (2.36-5.78) for males and 3.94 (2.70-5.75) for females. Similarly, the odds ratios for SAs were 5.04 (2.51-10.13) for males and 2.71 (1.48-4.98) for females, indicating a significant association between these limitations and increased suicidal behaviors, with variances observed between genders. These results underscore the necessity of addressing daily living and social activity restrictions when considering mental health interventions and suicide prevention strategies. In RF, GLM, and SVM, F1-score were 0.8192, 0.6887, and 0.9687 in SA, respectively. Among the patients with chronic disease, those with sequelae, low incomes, and low levels of education had limitations in daily activities and social activities, which increased the likelihood of suicidal thoughts, planning, and attempts.
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Affiliation(s)
- Myoungjee Jung
- Division of Cancer Screening, National Cancer Center, South Korea
| | - Kwang Ok Lee
- Department of Nursing, Sangmyung University, South Korea
| | - Hae-Rim Kim
- Department of Statistics, University of Seoul, South Korea
| | - Sang-Baek Koh
- Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, South Korea.
| | - Jeong-An Gim
- Department of Medical Science, Soonchunhyang University, South Korea.
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Batterham PJ, Poyser C, Gulliver A, Banfield M, Calear AL. Development and psychometric properties of the Functioning and Recovery Scale: a new measure to assess psychosocial functioning after a suicide attempt. Suicide Life Threat Behav 2020; 50:1105-1114. [PMID: 32744356 DOI: 10.1111/sltb.12656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 09/16/2019] [Accepted: 01/10/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Few measures have been developed to assess the efficacy of community-based suicide prevention and recovery services. The current study aimed to develop a scale to provide accurate assessment and monitoring of functional recovery for people following a recent suicide attempt at The Way Back Support Service in Australia. METHOD The study was conducted in multiple iterative stages: (1) literature review to identify existing scales; (2) structured informant interview with people with lived experience of a suicide attempt; (3) expert survey of researchers, clinicians, and people with lived experience on relevance and acceptability of candidate items; and (4) quantitative survey of the pilot scale to assess psychometric properties. RESULTS An 11-item scale assessing recovery in people who have recently attempted suicide was demonstrated to be a unidimensional measure with sound psychometric properties (α = 0.94). The scale was highly acceptable to researchers, clinicians, and people with lived experience. A short-form 6-item scale was also developed. CONCLUSIONS The Functioning and Recovery Scale is likely to be useful for evaluating suicide prevention programs. No existing scale captures the broad construct of psychosocial functioning with sound psychometric rigor and the involvement of people with lived experience of suicide attempt.
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Affiliation(s)
- Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Carmel Poyser
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Amelia Gulliver
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Michelle Banfield
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Alison L Calear
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
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Limitation on activities of daily living, depressive symptoms and suicidal ideation among nursing home residents: The moderating role of resilience. Geriatr Nurs 2020; 41:622-628. [DOI: 10.1016/j.gerinurse.2020.03.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 03/17/2020] [Accepted: 03/19/2020] [Indexed: 11/18/2022]
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Lövestad S, Löve J, Vaez M, Waern M, Hensing G, Krantz G. Suicidal ideation and attempts in population-based samples of women: temporal changes between 1989 and 2015. BMC Public Health 2019; 19:351. [PMID: 30922272 PMCID: PMC6440083 DOI: 10.1186/s12889-019-6685-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 03/20/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Little is known about temporal changes in the prevalence of self-reported suicidal ideation and attempts within general populations of women. The aim of this study was to assess the prevalence of self-reported suicidal ideation and attempts over a 26 year period (1989-2015) among women from the general population aged 20-49 years. A further aim was to investigate associations between sociodemographic factors and lifetime suicidal ideation over this study period. METHODS A total of 2072 structured personal interviews were performed with a stratified population-based sample of women between 1989 and 2015. Questions about lifetime suicidal ideation and attempts as well as sociodemographic factors were assessed at four data collection waves. Lifetime prevalence of suicidal ideation and attempts were compared through analysis of differences between two independent proportions and their 95% Confidence Intervals (CI). Associations between sociodemographic factors and lifetime suicidal ideation were estimated by weighted odds ratios (OR). RESULTS Women aged 20-30 years reported higher lifetime prevalence of suicidal ideation in 2013-2015 compared to 1989-1991 (45 and 33% respectively). Rates of lifetime suicide attempts remained similar between these time points (3.5 and 3.1% respectively). Women aged 31-49 years reported higher lifetime prevalence of suicidal ideation in 2013-2015 compared to 2000-2002 (35.4 and 23.1% respectively). In this age group, lifetime suicide attempts increased from 0.0% in 2000-2002 to 3.6% in 2013-2015. Women aged 20-30 years who were single, unemployed or had low educational attainment had higher OR of lifetime suicidal ideation compared to the reference categories in most of the study waves. In 2013-2015, young students had lower OR of lifetime suicidal ideation (OR 0.34; 95% CI 0.17-0.69) compared to those with employment. Women aged 31-49 years, who were single, had higher OR of lifetime suicidal ideation (OR 2.61; 95% CI 1.06-6.44) than married, cohabiting women and this was observed in 2013-2015. CONCLUSION The results raise a general concern about an increasing trend in suicidal ideation among young and middle-aged women. The current study expands on previous research by demonstrating that sociodemographic factors may show changing patterns in the associations with lifetime suicidal ideation over time.
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Affiliation(s)
- Solveig Lövestad
- Department of Community Medicine and Public Health, Sahlgrenska Academy at the University of Gothenburg, Box 453, 405 30, Göteborg, Sweden.
| | - Jesper Löve
- Department of Community Medicine and Public Health, Sahlgrenska Academy at the University of Gothenburg, Box 453, 405 30, Göteborg, Sweden
| | - Marjan Vaez
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Berzelius väg 3, 171 77, Stockholm, Sweden
| | - Margda Waern
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at University of Gothenburg, SU Sahlgrenska, 41345, Göteborg, Sweden
| | - Gunnel Hensing
- Department of Community Medicine and Public Health, Sahlgrenska Academy at the University of Gothenburg, Box 453, 405 30, Göteborg, Sweden
| | - Gunilla Krantz
- Department of Community Medicine and Public Health, Sahlgrenska Academy at the University of Gothenburg, Box 453, 405 30, Göteborg, Sweden
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Gomes DAR, de Araújo RMF, Gomes MS. Incidence of suicide among military police officers in South Brazil: An 11-year retrospective cohort study. Compr Psychiatry 2018; 85:61-66. [PMID: 29981945 DOI: 10.1016/j.comppsych.2018.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 05/31/2018] [Accepted: 06/16/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Suicide is known to be the leading cause of death among police officers (PO) worldwide. However, most studies were conducted in developed countries, with no data from Brazil. The present study aimed to evaluate the incidence and the sociodemographic profile of suicide among a military PO subpopulation in South Brazil. METHODS This retrospective cohort evaluated 31,110 military PO with available data on cause of death from 2006 to 2016. Participants were monitored for an average of 18.8 ± 9.6 years following the date of entry into the military police. RESULTS Mean age at the end of the follow up time was 41.4 ± 9.1 years, with 90.7% males. A total of 650 participants died (2.1%), with 43 suicides (6.6% of all deaths) - cumulative incidence of 138/100,000. Bivariate analysis revealed a significant association (p < 0.05) between suicide and age (HR = 0.70, 95%CI = 0.66-0.74), females (HR = 1.67, 95%CI = 1.08-2.60) and enlisted military rank (HR = 14.9, 95%CI = 2.05-108.5). Multivariate models showed an independent association between suicide and age (HR = 0.71, 95%CI = 0.67-0.74) and enlisted military rank (HR = 9.96, 95%CI = 1.30-76.3). CONCLUSIONS The incidence of suicide among military PO in South Brazil was high, compared to the national suicide rate. Younger age and lower military rank were independent predictors of suicide in this subpopulation.
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Affiliation(s)
- Denise Alves Riambau Gomes
- Department of Health of the Military Brigade of Rio Grande do sul, Brazil, Rua Castro de Menezes, 275, CEP 90010-190 Porto Alegre, RS, Brazil
| | - Rafael Moreno Ferro de Araújo
- Vale do Taquari University - Univates, Lajeado, Brazil, Rua Avelino Talini, 171, CEP 95914-014 Lajeado, RS, Brazil; Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil, Av. Ipiranga, 6681, prédio 6, CEP 90619900 Porto Alegre, RS, Brazil.
| | - Maximiliano Schünke Gomes
- Department of Health of the Military Brigade of Rio Grande do sul, Brazil, Rua Castro de Menezes, 275, CEP 90010-190 Porto Alegre, RS, Brazil; Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil, Av. Ipiranga, 6681, prédio 6, CEP 90619900 Porto Alegre, RS, Brazil.
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Norström T, Rossow I. Alcohol Consumption as a Risk Factor for Suicidal Behavior: A Systematic Review of Associations at the Individual and at the Population Level. Arch Suicide Res 2016; 20:489-506. [PMID: 26953621 DOI: 10.1080/13811118.2016.1158678] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The objective of this study was to provide an updated review of the magnitude of the relationship between alcohol use and suicidal behaviour at the individual and the population level. Systematic literature searches retrieved 14 reviews of individual level studies and 16 primary population level studies. Alcohol abuse and alcohol intoxication are often present in suicidal behaviour; risk of suicide is elevated in alcohol abusers and increasing population drinking tends to be associated with increase in suicide rates. Estimated magnitude of the relationship differs for men and women and it varies at the population level across cultures with different drinking pattern. These variations probably reflect gender differences and cultural variation in drinking behavior generally. Empirical evidence for a causal relationship is still urgently needed.
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Asadi R, Afshari R, Dadpour B. The measurement of disability weights for 18 prevalent acute poisoning conditions. Hum Exp Toxicol 2015; 35:1033-40. [PMID: 26655638 DOI: 10.1177/0960327115617229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Disability weights (DWs) are used in disease burden studies, with the calculation of the weight of the disability as years lived with disability versus years of lost life accounting for mortalities. Currently, there is a single DW score available for poisoning, which is considered to be a single health state. This makes it difficult to evaluate the differing burdens of poisonings involving various substances/conditions in comparison with other health states in countries with different patterns of substance abuse. The aim of this study is therefore to estimate the DWs of 18 common poisonings based on the expert elicitation method. METHODS A panel of 10 medical clinicians who were familiar with the clinical aspects of different poisonings estimated the DWs of 50 health states by interpolating them on a calibrated Visual Analogue Scale. The DWs of some poisonings, such as alcohol, cannabis and heroin, had been estimated in previous studies and so were used to determine the external consistency of our panel. As a matter of routine, the DWs could vary on a scale between 0 (best health state) and 1 (worst health state). RESULTS Statistical analysis showed that both the internal (Cronbach's α = 0.912) and external consistency of the panel were acceptable. The DWs for the different poisonings were estimated along a range from 0.830 for severe aluminium phosphide to 0.022 for mild benzodiazepine. CONCLUSIONS Different poisonings should be weighted differently since they vary widely. Unfortunately, they are currently all weighted the same.
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Affiliation(s)
- R Asadi
- Medical Toxicology Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - R Afshari
- Addiction Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran BC Disease Control Center, Vancouver, Canada
| | - B Dadpour
- Addiction Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
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Asadi R, Afshari R. Ten-year disease burden of acute poisonings in northeast Iran and estimations for national rates. Hum Exp Toxicol 2015; 35:747-59. [PMID: 26449646 DOI: 10.1177/0960327115604200] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Acute poisoning is a common health problem worldwide. Traditionally, the frequency of admitted cases, number of deaths or online resources were used to measure the volume of this problem. In this study, the burden of acute poisoning is addressed for the first time. METHODS Data related to 44,340 poisoned patients from 2004 to 2013 were analysed. Two sources including hospital information and forensic medicine data of the Khorasan Razavi catchment area. The disability-adjusted life years (DALY) method - including years of life lost (YLL) and years lived with disability (YLD) - was used to estimate the burden. RESULTS In this period and for all acute poisonings, the mean (SD, minimum-maximum) incidence of acute poisoning was 30,485 (3049 per year). In total, 29,208 DALY were lost, including 8499 YLD and 20,709 YLL. DALY have increased from 1808 in 2004 to 4283 in 2013. Among the total DALY over this 10-year period, 17,592 (60%) were related to males. Narcotic use accounted for the largest percentage of DALY (19.6%), followed by analgesics-sedative use (16.3%) and illegal drug use (11.41%). The health loss due to these causes was large (YLD = 8499 and YLL = 20,709) and showed a rapidly increasing trend. CONCLUSIONS Estimating DALY is more informative than using the frequency of death. If we expect the same ratio in the country, we would expect a DALY rate of 729,750 years for the 75,000,000 inhabitants of this country in this time period or 72,975 DALY lost per year for poisonings.
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Affiliation(s)
- R Asadi
- Medical Toxicology Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - R Afshari
- Medical Toxicology Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran Addiction Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
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Sgobin SMT, Traballi ALM, Botega NJ, Coelho OR. Direct and indirect cost of attempted suicide in a general hospital: cost-of-illness study. SAO PAULO MED J 2015; 133:218-26. [PMID: 26176926 PMCID: PMC10876379 DOI: 10.1590/1516-3180.2014.8491808] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 03/03/2014] [Accepted: 08/15/2014] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Knowledge of socioeconomic impact of attempted suicide may sensitize managers regarding prevention strategies. There are no published data on this in Brazil. The aim here was to describe the direct and indirect costs of care of hospitalized cases of attempted suicide and compare these with the costs of acute coronary syndrome cases. DESIGN AND SETTING Cost-of-illness study at a public university hospital in Brazil. METHOD The costs of care of 17 patients hospitalized due to attempted suicide were compared with those of 17 acute coronary syndrome cases at the same hospital, over the same period. The direct costs were the summation of the hospital and out-of-hospital costs resulting from the event, determined from the medical records. The indirect costs were estimated through the human capital lost. The Mann-Whitney test and analysis of covariance (ANCOVA) with transformation adjusted for age were used for comparisons. RESULTS The average costs per episode of attempted suicide were: direct cost, US$ 6168.65; indirect cost, US$ 688.08; and total cost, US$ 7163.75. Comparative analysis showed a difference between the indirect costs to family members, with significantly higher costs in the attempted suicide group (P = 0.0022). CONCLUSION The cost of care relating to attempted suicide is high and the indirect cost to family members reinforces the idea that suicidal behavior not only affects the individual but also his social environment.
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Affiliation(s)
- Sara Maria Teixeira Sgobin
- MSc. Collaborating Physician, Department of Medical Psychology and Psychiatry Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil.
| | - Ana Luisa Marques Traballi
- MD. Collaborating Physician, Department of Medical Psychology and Psychiatry Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil.
| | - Neury José Botega
- PhD. Titular Professor, Department of Medical Psychology and Psychiatry, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil.
| | - Otávio Rizi Coelho
- PhD. Titular Professor, Department of Cardiology, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil.
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Miret M, Caballero FF, Huerta-Ramírez R, Moneta MV, Olaya B, Chatterji S, Haro JM, Ayuso-Mateos JL. Factors associated with suicidal ideation and attempts in Spain for different age groups. Prevalence before and after the onset of the economic crisis. J Affect Disord 2014; 163:1-9. [PMID: 24836081 DOI: 10.1016/j.jad.2014.03.045] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 03/18/2014] [Accepted: 03/19/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Little is known about whether the prevalence of suicidal ideation and attempts has changed in the wake of the economic crisis. The aim of this study was to estimate current prevalence of suicidal ideation and attempts in the general population in Spain, to compare it with the prevalence found before the economic crisis, and to analyse the factors associated with suicidality in different age groups. METHODS A total of 4583 non-institutionalised adults were interviewed in a cross-sectional household survey of a nationally representative sample in Spain. Several modules of an adapted version of the Composite International Diagnostic Interview were administered to the participants, and logistic regression models were employed in each age group. RESULTS Lifetime prevalence of suicidal ideation and attempts in Spain were respectively, 3.67% and 1.46%. Mental disorders presented the highest significant effects on lifetime suicidal ideation. Marital status, heavy alcohol consumption, and occupational status were associated with lifetime suicidal ideation in people aged 18-49, whereas loneliness was associated with the 50-64 group, and financial problems with the 65+ group. A younger age, poor health status and the presence of depression were all associated with lifetime suicide attempts. LIMITATIONS The cross-sectional design of the study represents a methodological limitation. CONCLUSIONS The current prevalence of suicidal ideation and attempts in Spain is similar to the one found ten years ago, before the recent economic crisis. The factors associated with suicidality vary among age groups. Suicide prevention programmes should focus on early detection and prevention for depression and anxiety disorders.
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Affiliation(s)
- Marta Miret
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain
| | - Francisco Félix Caballero
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain
| | - Raúl Huerta-Ramírez
- Complejo Asistencial Benito Menni, Hermanas Hospitalarias, Ciempozuelos, Madrid, Spain
| | - María Victoria Moneta
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - Beatriz Olaya
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - Somnath Chatterji
- Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland
| | - Josep Maria Haro
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - José Luis Ayuso-Mateos
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain.
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Batterham PJ, Calear AL, Mackinnon AJ, Christensen H. The association between suicidal ideation and increased mortality from natural causes. J Affect Disord 2013; 150:855-60. [PMID: 23618327 DOI: 10.1016/j.jad.2013.03.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 02/04/2013] [Accepted: 03/24/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Despite strong evidence for increased suicide mortality among individuals experiencing thoughts of suicide, the effect of suicidal ideation on increased natural mortality has not been evaluated. The present study aimed to assess whether there is excess mortality from all natural causes or from specific natural causes that is attributable to suicidal ideation. Adjustments were made for a range of demographic, mental health and physical health measures to examine evidence for specific mechanisms of the relationship. METHOD A community-based Australian cohort of 861 older adults was followed for up to 17 years. Vital status and cause of death were ascertained from a national death registry. RESULTS After adjusting for demographics, physical health and mental health, presence of suicidal ideation was associated with a 23% increase in the risk of mortality from natural causes (p=0.034). The increased mortality was largely attributable to heart disease deaths (hazard ratio=1.43, p=0.041). LIMITATIONS There was a limited number of deaths from respiratory disease or stroke, and modest rates of suicidal ideation in the cohort. Assessment of suicidal ideation was brief, while adjustment for mental health symptoms relied on non-diagnostic measures. CONCLUSIONS Although the relationship between suicidal ideation and mortality from natural causes was partly explained by physical and mental health status, thoughts of suicide independently accounted for an increased risk of mortality. Further research should examine whether this relationship is mediated by poorer health behaviours among individuals experiencing thoughts of suicide.
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Affiliation(s)
- Philip J Batterham
- Centre for Mental Health Research, The Australian National University, Canberra, Australian Capital Territory, Australia.
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De Leo D. New Year's changes. CRISIS 2013; 34:1-2. [PMID: 23360678 DOI: 10.1027/0227-5910/a000204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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